Overview

What causes measles?Measles is caused by a virus and is best known by its typical skin rash although it is primarily a respiratory infection. Measles used to be called rubeola, but this term should not be used, to avoid confusion with a different disease that sounds similar: rubella.

How do I know if I have measles?Measles usually begins with a fever that lasts for a few days followed by a cough, runny nose, and “pink eye” (conjunctivitis). A characteristic rash inside the mouth (called Koplik spots) may be seen. A rash starts on the face and upper neck, spreads down the back and trunk, then extends to the arms, hands, legs, and feet. After about five days the rash fades in the same order it appeared. As the rash disappears, the healing skin may look brown temporarily, before it sheds in a finely textured peel.

How serious is measles, especially to the Armed Forces?Measles is unpleasant and its complications can be very serious. About one out of a thousand people infected with measles will develop acute encephalitis, an inflammation of the brain. This serious complication can lead to permanent brain damage. Measles during pregnancy increases the risk of premature labor, miscarriage, and low-birth-weight infants. Birth defects have not been linked to measles exposure. Measles can be especially severe in people with compromised immune systems. Six to 20 percent of people with measles will also develop an ear infection, diarrhea, or pneumonia. Complications from measles are more common among very young children (younger than five years old) and adults older than 20 years of age. For every thousand people infected with measles, 1 to 2 die.

Is there a treatment for measles?There is no specific treatment for measles. People with measles need bed rest, fluids, and control of fever. Patients with complications may need treatment specific to their problem.

Rate and Spread

How common is measles in the United States?

Before a vaccine was licensed in1963, there were an estimated 3 to 4 million cases of measles each year. In the years following 1963, the number of measles cases dropped dramatically, with only 1,497 cases in 1983, the lowest annual total reported up to that time.

From 1989 to 1991, 55,622 cases were reported with a total of 123 measles-associated deaths. Half of the cases and deaths were in young children. The most important cause of this epidemic was low immunization rates among preschool-age children. Due to increased immunization efforts after this epidemic, measles cases fell during the 1990s. Only 44 cases were reported in 2002. However, measles is still common in many other countries in the world and can easily be imported, so continued immunization against the disease is still important.

How does measles spread from one person to another?Measles is highly contagious. Infected people are usually contagious from about 4 days before their rash starts and for up to 4 days afterwards. The measles virus resides in the mucus in the nose and throat of infected people. When they sneeze or cough, droplets spray into the air and the droplets remain active and contagious on infected surfaces for up to 2 hours.

How long is someone with measles contagious?Measles is highly contagious and can be transmitted from 4 days before the rash becomes visible to 4 days after the rash appears.

Can you get measles more than once?No.

If I think someone has been exposed to measles, what should I do?Refer anyone exposed to measles to their doctor immediately. If a child has not been vaccinated, measles vaccine may prevent illness if given within 72 hours of exposure. Immune globulin (a blood product containing antibodies to the measles virus) may prevent or lessen the severity of measles if given within 6 days of exposure.